Department of Pediatrics, Division of Infectious Diseases, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA 30322, United States.
Semin Immunol. 2013 Apr;25(2):160-71. doi: 10.1016/j.smim.2013.04.011. Epub 2013 Jun 15.
The importance of RSV as a respiratory pathogen in young children made it a priority for vaccine development shortly after it was discovered. Unfortunately, after over 50 years of vaccine development no vaccine has yet been licensed and it is not certain which if any vaccines being developed will be successful. The first candidate vaccine, a formalin inactivated RSV vaccine (FI-RSV), was tested in children in the 1960s and predisposed young recipients to more serious disease with later natural infection. The ongoing challenges in developing RSV vaccines are balanced by advances in our understanding of the virus, the host immune response to vaccines and infection, and pathogenesis of disease. It seems likely that with efficient and appropriately focused effort a safe and effective vaccine is within reach. There are at least 4 different target populations for an RSV vaccine, i.e. the RSV naïve young infant, the RSV naïve infant >4-6 months of age, pregnant women, and elderly adults. Each target population has different issues related to vaccine development. Numerous vaccines from live attenuated RSV to virus like particle vaccines have been developed and evaluated in animals. Very few vaccines have been studied in humans and studies in humans are needed to determine which vaccines are worth moving toward licensure. Some changes in the approach may improve the efficiency of evaluating candidate vaccines. The complexity of the challenges for developing RSV vaccines suggests that collaboration among academic, government, and funding institutions and industry is needed to most efficiently achieve an RSV vaccine.
呼吸道合胞病毒（RSV）作为一种主要的小儿呼吸道病原体，在被发现后不久便成为疫苗研发的重点。不幸的是，经过 50 多年的疫苗研发，目前尚无疫苗获得许可，也不确定正在开发的疫苗中哪些会成功。第一个候选疫苗是福尔马林灭活 RSV 疫苗（FI-RSV），它在 20 世纪 60 年代在儿童中进行了测试，使年幼的接种者在随后的自然感染中更容易患更严重的疾病。在开发 RSV 疫苗方面面临的持续挑战，与我们对病毒、宿主对疫苗和感染的免疫反应以及疾病发病机制的理解的进步相平衡。似乎只要投入高效且有针对性的努力，就有可能研发出安全有效的疫苗。至少有 4 种不同的 RSV 疫苗目标人群，即 RSV 初免的婴儿、4-6 月龄以上的 RSV 初免婴儿、孕妇和老年人。每个目标人群在疫苗开发方面都有不同的问题。已经开发并在动物中评估了许多 RSV 疫苗，包括活减毒 RSV 疫苗到病毒样颗粒疫苗。在人类中研究的疫苗很少，需要在人类中进行研究，以确定哪些疫苗值得获得许可。改变方法可能会提高评估候选疫苗的效率。开发 RSV 疫苗的挑战的复杂性表明，需要学术、政府、资助机构和行业之间的合作，以最有效地实现 RSV 疫苗。
